Fall Semester 2026–2027 ATI230 – ATI Maternal-
Newborn Proctored Updated 2026 | 190+ Questions
and Answers | ATI230 Maternal-Newborn Nursing
Comprehensive Study Guide, Practice Exam, Exam Prep
Test Bank, Antepartum Care, Labor and Delivery,
Postpartum Nursing, Newborn Assessment, Neonatal
Care, High-Risk Pregnancy, Obstetric Emergencies,
Breastfeeding, Clinical Judgment, NCLEX-RN Review,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is at 38 weeks of gestation and is
experiencing preeclampsia with severe features. Which of the following
findings should the nurse report to the provider immediately?
A. Blood pressure 158/92 mm Hg
B. Urine protein 2+
C. Platelet count 98,000/mm³
D. Mild headache
CORRECT ANSWER: C. Platelet count 98,000/mm³
Rationale: A platelet count of less than 100,000/mm³ in a client with preeclampsia with
severe features indicates HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets). This is a life-threatening complication that requires immediate intervention,
often delivery. While the other findings are also concerning in preeclampsia, the platelet
count is the most critical and emergent finding.
Question 2: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Respiratory rate 42 breaths/min
B. Heart rate 148 beats/min
C. Grunting on expiration
D. Acrocyanosis
CORRECT ANSWER: C. Grunting on expiration
Rationale: Grunting on expiration is an indication of respiratory distress in a newborn,
often signifying the infant is trying to maintain functional residual capacity and prevent
alveolar collapse. This is an abnormal finding that requires prompt evaluation.
Acrocyanosis, a heart rate of 148 bpm, and a respiratory rate of 42 breaths/min are all
normal findings in a newborn.
Question 3: A nurse is providing education to a postpartum client about
breastfeeding. Which of the following statements by the client indicates a need
for further teaching?
,A. "I should feed my baby at least 8 to 12 times in 24 hours."
B. "If my breasts feel hard and painful, I should stop breastfeeding."
C. "I should hear swallowing sounds during feeding."
D. "I will alternate which breast I start with at each feeding."
CORRECT ANSWER: B. "If my breasts feel hard and painful, I should stop
breastfeeding."
Rationale: Hard, painful breasts are a sign of engorgement. The client should continue
breastfeeding frequently to relieve engorgement, not stop. Stopping will worsen the
condition and decrease milk supply. The other statements reflect correct understanding
of breastfeeding principles.
Question 4: A nurse is performing a fundal assessment on a client who is 24
hours postpartum. The nurse locates the fundus at the level of the umbilicus
and deviated to the right. Which of the following actions should the nurse take
first?
A. Massage the fundus
B. Assist the client to void
C. Administer oxytocin
D. Notify the provider
CORRECT ANSWER: B. Assist the client to void
Rationale: A fundus that is deviated to the side, particularly to the right, is often
displaced by a full bladder. The nurse's priority action is to have the client void, which
will allow the uterus to contract and center in the midline. Massaging the fundus and
administering oxytocin may be necessary if the uterus is boggy, but addressing the
bladder is the first step.
Question 5: A nurse is caring for a client in active labor who has an epidural
anesthesia block. Which of the following assessments is the priority?
A. Fetal heart rate
B. Maternal blood pressure
C. Pain level
D. Urinary output
CORRECT ANSWER: B. Maternal blood pressure
Rationale: The priority assessment for a client with an epidural is maternal blood
pressure because the most common complication is hypotension due to sympathetic
blockade. Hypotension can lead to decreased placental perfusion and fetal distress.
While all assessments are important, blood pressure is the priority.
,Question 6: A nurse is preparing to administer Rh(D) immune globulin to a
client. Which of the following clients is eligible to receive this medication?
A. A client who is Rh-negative and has an Rh-positive newborn
B. A client who is Rh-positive and has an Rh-negative newborn
C. A client who is Rh-negative and has an Rh-negative newborn
D. A client who is Rh-positive and has an Rh-positive newborn
CORRECT ANSWER: A. A client who is Rh-negative and has an Rh-positive
newborn
Rationale: Rh(D) immune globulin is administered to Rh-negative clients who have given
birth to an Rh-positive newborn to prevent maternal isoimmunization. It works by
destroying Rh-positive fetal RBCs in the maternal circulation before the mother can
mount an antibody response.
Question 7: A nurse is assessing a client who is at 35 weeks of gestation and
has placenta previa. Which of the following findings should the nurse expect?
A. Severe abdominal pain
B. Firm, rigid uterus
C. Painless vaginal bleeding
D. Late decelerations on fetal monitoring
CORRECT ANSWER: C. Painless vaginal bleeding
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester because the placenta is implanted over the cervical os. Pain
and a rigid uterus are characteristic of placental abruption.
Question 8: A nurse is caring for a newborn who is 1 hour old. Which of the
following actions should the nurse take to prevent heat loss through
convection?
A. Place the newborn on a warm radiant warmer
B. Dry the newborn immediately after birth
C. Place a hat on the newborn's head
D. Keep the newborn away from open windows and air vents
CORRECT ANSWER: D. Keep the newborn away from open windows and air
vents
Rationale: Convection is heat loss that occurs when a cool air current passes over the
skin. Keeping the newborn away from drafts, open windows, and air vents minimizes
heat loss by convection. Placing the newborn on a radiant warmer prevents conduction
and radiation, drying prevents evaporation, and placing a hat prevents radiation and
convection from the head.
, Question 9: A nurse is teaching a client about the use of a breast pump. Which
of the following instructions should the nurse include?
A. Use the pump for 45 minutes on each breast
B. Place the pump parts in the dishwasher to sterilize them
C. Replace the pump membranes every 3 to 6 months
D. Use a breast pump that is larger than the areola
CORRECT ANSWER: C. Replace the pump membranes every 3 to 6 months
Rationale: Pump membranes (or valves) should be replaced every 3 to 6 months to
maintain suction and proper milk expression. The other statements are incorrect:
pumping should be about 10-15 minutes per breast or until milk flow stops, sterilizing
should be done by boiling (not dishwasher), and the flange should be appropriately
sized, not larger than the areola.
Question 10: A nurse is assessing a client who is in the transition phase of
labor. Which of the following findings should the nurse expect?
A. A feeling of being "out of control"
B. Contractions lasting 30 to 45 seconds
C. Cervical dilation from 4 to 7 cm
D. Strong urge to push
CORRECT ANSWER: A. A feeling of being "out of control"
Rationale: The transition phase is the most intense part of the first stage of labor,
characterized by cervical dilation from 8 to 10 cm and contractions lasting 60-90
seconds. Clients often experience a feeling of being "out of control," irritability, and
restlessness due to the intensity of the contractions. The urge to push typically occurs in
the second stage.
Question 11: A nurse is reviewing the laboratory results of a client who is at 28
weeks of gestation. Which of the following results should the nurse report to
the provider?
A. Hemoglobin 11.2 g/dL
B. Platelet count 220,000/mm³
C. Glucose 1-hour 50-g screen 155 mg/dL
D. WBC count 12,000/mm³
CORRECT ANSWER: C. Glucose 1-hour 50-g screen 155 mg/dL
Rationale: A result of 155 mg/dL on the 1-hour glucose tolerance test is above the
normal cutoff of 130-140 mg/dL, indicating the need for a 3-hour glucose tolerance test
Newborn Proctored Updated 2026 | 190+ Questions
and Answers | ATI230 Maternal-Newborn Nursing
Comprehensive Study Guide, Practice Exam, Exam Prep
Test Bank, Antepartum Care, Labor and Delivery,
Postpartum Nursing, Newborn Assessment, Neonatal
Care, High-Risk Pregnancy, Obstetric Emergencies,
Breastfeeding, Clinical Judgment, NCLEX-RN Review,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is at 38 weeks of gestation and is
experiencing preeclampsia with severe features. Which of the following
findings should the nurse report to the provider immediately?
A. Blood pressure 158/92 mm Hg
B. Urine protein 2+
C. Platelet count 98,000/mm³
D. Mild headache
CORRECT ANSWER: C. Platelet count 98,000/mm³
Rationale: A platelet count of less than 100,000/mm³ in a client with preeclampsia with
severe features indicates HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets). This is a life-threatening complication that requires immediate intervention,
often delivery. While the other findings are also concerning in preeclampsia, the platelet
count is the most critical and emergent finding.
Question 2: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Respiratory rate 42 breaths/min
B. Heart rate 148 beats/min
C. Grunting on expiration
D. Acrocyanosis
CORRECT ANSWER: C. Grunting on expiration
Rationale: Grunting on expiration is an indication of respiratory distress in a newborn,
often signifying the infant is trying to maintain functional residual capacity and prevent
alveolar collapse. This is an abnormal finding that requires prompt evaluation.
Acrocyanosis, a heart rate of 148 bpm, and a respiratory rate of 42 breaths/min are all
normal findings in a newborn.
Question 3: A nurse is providing education to a postpartum client about
breastfeeding. Which of the following statements by the client indicates a need
for further teaching?
,A. "I should feed my baby at least 8 to 12 times in 24 hours."
B. "If my breasts feel hard and painful, I should stop breastfeeding."
C. "I should hear swallowing sounds during feeding."
D. "I will alternate which breast I start with at each feeding."
CORRECT ANSWER: B. "If my breasts feel hard and painful, I should stop
breastfeeding."
Rationale: Hard, painful breasts are a sign of engorgement. The client should continue
breastfeeding frequently to relieve engorgement, not stop. Stopping will worsen the
condition and decrease milk supply. The other statements reflect correct understanding
of breastfeeding principles.
Question 4: A nurse is performing a fundal assessment on a client who is 24
hours postpartum. The nurse locates the fundus at the level of the umbilicus
and deviated to the right. Which of the following actions should the nurse take
first?
A. Massage the fundus
B. Assist the client to void
C. Administer oxytocin
D. Notify the provider
CORRECT ANSWER: B. Assist the client to void
Rationale: A fundus that is deviated to the side, particularly to the right, is often
displaced by a full bladder. The nurse's priority action is to have the client void, which
will allow the uterus to contract and center in the midline. Massaging the fundus and
administering oxytocin may be necessary if the uterus is boggy, but addressing the
bladder is the first step.
Question 5: A nurse is caring for a client in active labor who has an epidural
anesthesia block. Which of the following assessments is the priority?
A. Fetal heart rate
B. Maternal blood pressure
C. Pain level
D. Urinary output
CORRECT ANSWER: B. Maternal blood pressure
Rationale: The priority assessment for a client with an epidural is maternal blood
pressure because the most common complication is hypotension due to sympathetic
blockade. Hypotension can lead to decreased placental perfusion and fetal distress.
While all assessments are important, blood pressure is the priority.
,Question 6: A nurse is preparing to administer Rh(D) immune globulin to a
client. Which of the following clients is eligible to receive this medication?
A. A client who is Rh-negative and has an Rh-positive newborn
B. A client who is Rh-positive and has an Rh-negative newborn
C. A client who is Rh-negative and has an Rh-negative newborn
D. A client who is Rh-positive and has an Rh-positive newborn
CORRECT ANSWER: A. A client who is Rh-negative and has an Rh-positive
newborn
Rationale: Rh(D) immune globulin is administered to Rh-negative clients who have given
birth to an Rh-positive newborn to prevent maternal isoimmunization. It works by
destroying Rh-positive fetal RBCs in the maternal circulation before the mother can
mount an antibody response.
Question 7: A nurse is assessing a client who is at 35 weeks of gestation and
has placenta previa. Which of the following findings should the nurse expect?
A. Severe abdominal pain
B. Firm, rigid uterus
C. Painless vaginal bleeding
D. Late decelerations on fetal monitoring
CORRECT ANSWER: C. Painless vaginal bleeding
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester because the placenta is implanted over the cervical os. Pain
and a rigid uterus are characteristic of placental abruption.
Question 8: A nurse is caring for a newborn who is 1 hour old. Which of the
following actions should the nurse take to prevent heat loss through
convection?
A. Place the newborn on a warm radiant warmer
B. Dry the newborn immediately after birth
C. Place a hat on the newborn's head
D. Keep the newborn away from open windows and air vents
CORRECT ANSWER: D. Keep the newborn away from open windows and air
vents
Rationale: Convection is heat loss that occurs when a cool air current passes over the
skin. Keeping the newborn away from drafts, open windows, and air vents minimizes
heat loss by convection. Placing the newborn on a radiant warmer prevents conduction
and radiation, drying prevents evaporation, and placing a hat prevents radiation and
convection from the head.
, Question 9: A nurse is teaching a client about the use of a breast pump. Which
of the following instructions should the nurse include?
A. Use the pump for 45 minutes on each breast
B. Place the pump parts in the dishwasher to sterilize them
C. Replace the pump membranes every 3 to 6 months
D. Use a breast pump that is larger than the areola
CORRECT ANSWER: C. Replace the pump membranes every 3 to 6 months
Rationale: Pump membranes (or valves) should be replaced every 3 to 6 months to
maintain suction and proper milk expression. The other statements are incorrect:
pumping should be about 10-15 minutes per breast or until milk flow stops, sterilizing
should be done by boiling (not dishwasher), and the flange should be appropriately
sized, not larger than the areola.
Question 10: A nurse is assessing a client who is in the transition phase of
labor. Which of the following findings should the nurse expect?
A. A feeling of being "out of control"
B. Contractions lasting 30 to 45 seconds
C. Cervical dilation from 4 to 7 cm
D. Strong urge to push
CORRECT ANSWER: A. A feeling of being "out of control"
Rationale: The transition phase is the most intense part of the first stage of labor,
characterized by cervical dilation from 8 to 10 cm and contractions lasting 60-90
seconds. Clients often experience a feeling of being "out of control," irritability, and
restlessness due to the intensity of the contractions. The urge to push typically occurs in
the second stage.
Question 11: A nurse is reviewing the laboratory results of a client who is at 28
weeks of gestation. Which of the following results should the nurse report to
the provider?
A. Hemoglobin 11.2 g/dL
B. Platelet count 220,000/mm³
C. Glucose 1-hour 50-g screen 155 mg/dL
D. WBC count 12,000/mm³
CORRECT ANSWER: C. Glucose 1-hour 50-g screen 155 mg/dL
Rationale: A result of 155 mg/dL on the 1-hour glucose tolerance test is above the
normal cutoff of 130-140 mg/dL, indicating the need for a 3-hour glucose tolerance test
